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WATER TEST REQUEST
FOR REAL ESTATE CLOSING
Before beginning...
Many of your questions can be answered here
*
Indicates required field
Seller's Full Name
*
Purchaser's Full Name
*
Sample Site Address (including City)
*
A Mileage Charge will apply if property is located outside of Gloucester, Mathews, or Middlesex.
Outside Faucet Accessible?
*
Yes
No
Unrestricted access (no dogs, locked gates, etc.) is required to an outside faucet with running water (power and pump on). This allows us to collect a sample without someone being present. If there are special access circumstances, please provide instructions.
Lockbox or gate code:
*
Home Occupied
*
Yes
No
If the home is NOT occupied, we recommend a chlorination.
If we go out to sample and there is no running water or power on, an additional $55 charge will be incurred.
Water treatment equipment?
*
Yes
No
If there is a whole house water treatment unit, we may need to access it.
If water treatment is present, where is it currently located?
*
Upfront payment is required before sampling will be done. Please provide the contact name, email address, and phone number of person paying Invoice online and receiving test results.
Contact Name
*
Contact Phone Number
*
Contact Email
*
If you would like the Invoice and test results to be sent to an additional party, please fill out below.
Additional Contact Name & Phone Number
*
Additional Contact Email
*
Tests to be Ordered*
*
Bacteria Test & Chlorination** $195
Lead Test $95
Nitrate/Nitrite Test $104
Bacteria Test, Chlorination, Lead, & Nitrate/Nitrate $340
FHA Sketch & Letter $125
Pump & Well Tank Inspection $175
Pump & Well Tank Inspection with Other Service $120
Free Water Analysis to recommend water treatment
You will need to confirm with loan underwriter/mortgage company what tests they are requiring for the loan.
* If you are unsure of what tests are needed, please contact the loan underwriter. We can not advise you on what tests to order.
**Chlorination included with Bacteria Test means we will provide a chlorination of the well, line, or sample point as the configuration allows. If the bacteria test fails, we will provide the second bacteria test at no additional charge (excluding Mileage Charge).
Please allow 5 - 7 business days for results from the date of sampling.
Well Pump & Pressure Tank location(s) if Pump & Well Tank inspection requested
*
Closing Date
*
Please Note test results are only good for 30 days.
Please Note test results are only good for 30 days.
Additional Information
*
Please Note: All Required Fields marked with
*
must be answered/completed or test will not Submit.
Please make sure you receive the following message to confirm your request went through: "Thank you. Your request has been submitted."
Please contact Petra at 804-693-7294, option 2 or
[email protected]
with any questions.
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Homeowners
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Homeowners
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Commercial
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FAQ
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Still Have Questions